Configuración del desarrollo territorial en el contexto de la Nueva Ruralidad en el sur del Estado de México

El territorio como fenómeno presupone dos dimensiones (construcción social y construcción política) y dos propiedades (factor y agente) para el desarrollo. En tal sentido, el desarrollo territorial denota un proceso multidimensional y endógeno de construcción socializada en el espacio geográfico. En relación, la primera fase de este documento consistió en analizar estructura, organización y patrón territorial; que sustentan bienestar social, dinámica socioeconómica endógena y estado de desarrollo de una región particular. La base metodológica concatenó siete nociones territoriales de configuración socio-espacial, cinco componentes del proceso multidimensional, planos de endogeneidad y matrices del estado de desarrollo. Los resultados evidenciaron el diferencial territorial endógeno que configuró cuatro tipos de territorios homologados por sector y actividad socioeconómica, pero diferenciados por la intervención pública. Se concluye que el territorio es el vector de construcción social-política y de un estado relativo y temporal de desarrollo. Así mismo los espacios rurales han experimentado una serie de transformaciones socioeconómicas y espaciales resultado de los modelos y políticas de desarrollo implementadas durante los últimos 60 años. Los cambios han propiciado la aparición o consolidación de procesos relacionados con el grado de modernización técnico-productiva de la actividad agrícola, procesos de tercerización y crecimiento de la prestación de servicios en el medio rural, sustitución de cultivos tradicionales por los de exportación, cambios en los mercados de trabajo no agrícola, estímulo de actividades no agrícolas, así como preservación del ambiente. Estos procesos evidencian la complejidad de lo local-rural, así como la necesidad de considerar nuevas aproximaciones analíticas que incorporen una perspectiva que considere las transformaciones socioeconómicas. Este trabajo considera la evolución de la relación rural-urbana en tres aspectos clave de concepción; de estática, homogénea y dicotómica hacia dinámica, heterogénea y territorial. Así mismo, si bien esta evolución es auspiciada por el modelo de desarrollo económico prevaleciente, enfatiza que se debe dejar de lado la conceptualización de espacio de reproducción de actividades agropecuarias con baja densidad demográfica para transitar hacia espacios de convergencia pluriactivos. Por lo anterior, la segunda fase del presente documento, recurre a las categorías de Nueva Ruralidad como marco interpretativo de los procesos sociales, económicos y espaciales en los entornos rurales con el propósito de integrar diferentes categorías en una serie de índices de evidencia empírica de las trasformaciones en el territorio. Si bien la Nueva Ruralidad no puede considerarse hasta hoy en día un enfoque de análisis, si como marco de referencia para interpretar los cambios y transformaciones en la relación rural-urbana y sus procesos socioeconómicos desde una perspectiva dinámica, heterogénea y territorial. La capacidad explicativa de las categorías de la Nueva Ruralidad hace necesario delimitar un contexto teórico. En este caso multidimensionalidad y territorio mostraron su alcance teórico-práctico al momento de interpretar lo rural desde lo dinámico y heterogéneo

La estructuración y relatividad del desarrollo desde la complejidad territorial y el caos de los conglomerados florícolas

El desarrollo como fenómeno social, ha transitado de la objetividad que lo situaba como un problema de orden material, cuya solución requería de la consecución de etapas evolutivas de los sistemas productivos y los factores de producción, para el incremento de la productividad de los sectores económicos. Hacia la noción subjetiva, donde se privilegia el bienestar individual y colectivo en su dimensión humana, asociada a elementos como: justica social, participación democrática, incremento de las libertades, salud y educación. En este contexto, el desarrollo se concibe como una propiedad emergente resultado de la convergencia de elementos materiales e inmateriales; los cuales tienden organizarse temporal y espacialmente. La organización espacial o sistema territorial expresa la sinergia de dos componentes endógeno y autoorganización. Lo endógeno se vincula a las características sociales, económicas e institucionales de un lugar determinado; las cuales se relacionan para conformar patrones estructructurales de funcionamiento. La autoorganización es una propiedad que emerge en el sistema territorial, que le permite construir estrategias de transformación y adaptación frente a perturbaciones provenientes de tres contextos exo-territoriales; mercado, políticas públicas y competitividad. La sinergia entre la endogeneidad y autoorganización propician la dinámica de las estructuras funcionales que conforman al sistema territorial. La dinámica es una cualidad que explica la temporalidad del desarrollo en un sistema territorial; la temporalidad es una dimensión que describe la complejidad del desarrollo, al concebirlo como un estado momentáneo y relativo de organización de tres estructuras: social, productiva y organizacional. El desarrollo en tanto propiedad emergente requiere de la búsqueda de alternativas epistémicas, teóricas y metodológicas que destaquen las cualidades del desarrollo como fenómeno complejo, resultado de la interacción de componentes materiales e inmateriales. En este sentido el presente trabajo tiene como objetivo explicar el clúster florícola del sur del Estado de México como sistema territorial adaptativo, en un contexto de complejidad del desarrollo

Adaptación a los cambios ambientales y territoriales

En este libro se abordan temáticas que destacan la adaptación de los distintos sectores de población a los cambios ambientales y territoriales, la cual muestra las respuestas a la incidencia de los estímulos del entorno, económico, social y ambiental. Así, se destaca la exposición de la población a los efectos destructivos de las amenazas y peligros naturales, lo que ha despertado interés en conocer sus causas, prevenir y mitigar el daño. A través de la revisión de estudios se induce la aprehensión de un tema que adquiere importancia en el contexto de los impactos globales, regionales y locales que se producen como consecuencia de la vulnerabilidad estructural característica de los países en desarrollo.En este libro se proponen estrategias de prevención ante la ocurrencia periódica de inundación en San Mateo Atenco, Estado de México y se analizan los factores sociales que inciden en el deterioro del bosque templado en San Lorenzo Huitzitzilapan. También se exponen soluciones para que se mejoren la condición del bosque y la calidad de vida de la población.Proyecto realizado con financiamiento de la Secretaría de Educación Pública-Subsecretaría de Educación Superior-Dirección General de Educación Superior Universitaria. Número del convenio con la SEP: 2017-15-001-017

Brain clocks capture diversity and disparities in aging and dementia

Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging.</p

Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations

Peer reviewe

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations

Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging

An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients

Background: Whilst timely clinical characterisation of infections caused by novel SARS-CoV-2 variants is necessary for evidence-based policy response, individual-level data on infecting variants are typically only available for a minority of patients and settings. Methods: Here, we propose an innovative approach to study changes in COVID-19 hospital presentation and outcomes after the Omicron variant emergence using publicly available population-level data on variant relative frequency to infer SARS-CoV-2 variants likely responsible for clinical cases. We apply this method to data collected by a large international clinical consortium before and after the emergence of the Omicron variant in different countries. Results: Our analysis, that includes more than 100,000 patients from 28 countries, suggests that in many settings patients hospitalised with Omicron variant infection less often presented with commonly reported symptoms compared to patients infected with pre-Omicron variants. Patients with COVID-19 admitted to hospital after Omicron variant emergence had lower mortality compared to patients admitted during the period when Omicron variant was responsible for only a minority of infections (odds ratio in a mixed-effects logistic regression adjusted for likely confounders, 0.67 [95% confidence interval 0.61-0.75]). Qualitatively similar findings were observed in sensitivity analyses with different assumptions on population-level Omicron variant relative frequencies, and in analyses using available individual-level data on infecting variant for a subset of the study population. Conclusions: Although clinical studies with matching viral genomic information should remain a priority, our approach combining publicly available data on variant frequency and a multi-country clinical characterisation dataset with more than 100,000 records allowed analysis of data from a wide range of settings and novel insights on real-world heterogeneity of COVID-19 presentation and clinical outcome

Implementation of Recommendations on the Use of Corticosteroids in Severe COVID-19

Importance: Research diversity and representativeness are paramount in building trust, generating valid biomedical knowledge, and possibly in implementing clinical guidelines. Objectives: To compare variations over time and across World Health Organization (WHO) geographic regions of corticosteroid use for treatment of severe COVID-19; secondary objectives were to evaluate the association between the timing of publication of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial (June 2020) and the WHO guidelines for corticosteroids (September 2020) and the temporal trends observed in corticosteroid use by region and to describe the geographic distribution of the recruitment in clinical trials that informed the WHO recommendation. Design, setting, and participants: This prospective cohort study of 434 851 patients was conducted between January 31, 2020, and September 2, 2022, in 63 countries worldwide. The data were collected under the auspices of the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC)-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Analyses were restricted to patients hospitalized for severe COVID-19 (a subset of the ISARIC data set). Exposure: Corticosteroid use as reported to the ISARIC-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Main outcomes and measures: Number and percentage of patients hospitalized with severe COVID-19 who received corticosteroids by time period and by WHO geographic region. Results: Among 434 851 patients with confirmed severe or critical COVID-19 for whom receipt of corticosteroids could be ascertained (median [IQR] age, 61.0 [48.0-74.0] years; 53.0% male), 174 307 (40.1%) received corticosteroids during the study period. Of the participants in clinical trials that informed the guideline, 91.6% were recruited from the United Kingdom. In all regions, corticosteroid use for severe COVID-19 increased, but this increase corresponded to the timing of the RECOVERY trial (time-interruption coefficient 1.0 [95% CI, 0.9-1.2]) and WHO guideline (time-interruption coefficient 1.9 [95% CI, 1.7-2.0]) publications only in Europe. At the end of the study period, corticosteroid use for treatment of severe COVID-19 was highest in the Americas (5421 of 6095 [88.9%]; 95% CI, 87.7-90.2) and lowest in Africa (31 588 of 185 191 [17.1%]; 95% CI, 16.8-17.3). Conclusions and relevance: The results of this cohort study showed that implementation of the guidelines for use of corticosteroids in the treatment of severe COVID-19 varied geographically. Uptake of corticosteroid treatment was lower in regions with limited clinical trial involvement. Improving research diversity and representativeness may facilitate timely knowledge uptake and guideline implementation